椎間板変性疾患におけるヒト髄液中のサイトカイン解析について--Matrix Metalloproteinasesを中心に

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Spinal fluid was collected from 26 patients with degenerative disc diseases (11 with lumbar disc herniation and 15 with lumbar spinal canal stenosis) and 4 healthy subjects when myelography or spinal anesthesia for surgery was performed, and the levels of major cytokines that are known to cause disc degeneration were measured. Cell cytometry and fractionation were performed. Levels of IL-1β and TNF-a, TGF-β were analyzed by ELISA: matrix metalloprotease (MMP) -3 and MMP-9, a tissue inhibitor of metalloproteinase (TIMP) -1 and TIMP-2 by enzyme immunoassay; and IL-6 by chemiluminescent enzyme immunoassay. Disc degeneration was evaluated by MRI and classified into 5 grades (from 0 to 4) . In the clinical evaluations prior to and post-surgery, the Japanese Orthopaedic Association scoring system was used. The levels of MMPs in the spinal fluid from the patients with lumbar disc herniation and lumbar spinal canal stenosis were significantly higher than those in the spinal fluid from healthy subjects. The severity of disc degeneration was not associated with the levels of MMPs. Of the patients with lumbar spinal canal stenosis, levels of MMPs were higher in patients with cauda equina syndrome than in patients with radiculopathy. The levels of IL-6 and TIMP-1 were significantly higher in patients with lumbar spinal canal stenosis (in both patients with cauda equina syndrome and those with radiculopathy) than in those with lumbar disc herniation. There was no significant difference between patients with lumbar spinal canal stenosis and those with lumbar disc herniation with respect to the number of cells and cell fractions. These results indicate that MMPs, TIMPs and the above-mentioned cytokines are also produced in the spinal canal and are involved in the degeneration of discs and spinal nerves.
学校法人昭和大学・昭和医学会の論文

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尾又弘晃
昭和大学医学部整形外科学教室

椎間板変性疾患におけるヒト髄液中のサイトカイン解析について--Matrix Metalloproteinasesを中心に

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